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Multifaceted quality improvement initiatives improve rate of pediatric hand injury reduction

Marisa Market1,2, Julia Zhu-Pawlowsky3,4, Maala Bhatt5

  • 1University of Ottawa, Ottawa, ON, Canada. mmark030@uottawa.ca.

CJEM
|March 29, 2022
PubMed

Insights

Quality improvement initiatives significantly reduced repeat reductions for pediatric hand fractures in the emergency department. Multifaceted interventions, including specialized surgeons and electronic records, improved patient care and reduced complications.

Area of Science:

  • Pediatric Orthopedics
  • Quality Improvement in Healthcare
  • Emergency Medicine

Background:

  • Hand fractures are common in pediatric emergency departments, necessitating effective initial treatment.
  • Repeat interventions for pediatric hand fractures can lead to complications and increased healthcare costs.

Purpose of the Study:

  • To assess the impact of quality improvement interventions on reducing repeat surgical reductions for pediatric hand fractures.
  • To evaluate the effectiveness of a multifaceted approach in improving initial management of pediatric hand injuries.

Main Methods:

  • A quality improvement project was conducted over two plan-do-study-act cycles involving 272 pediatric patients with hand injuries.
  • Interventions included disseminating research, hiring a pediatric hand surgeon, implementing electronic medical records, educational workshops, and standardized flowsheets.

Main Results:

  • The rate of hand fractures requiring repeat reduction decreased from 8.7% to 3.0% after the first cycle.
  • This significant improvement was sustained in the second cycle, with the rate remaining at 3.0% over 17 months.

Conclusions:

  • Multifaceted quality improvement interventions are crucial for enhancing patient care in pediatric hand injuries.
  • Specialized physicians, education, and improved record-keeping contribute to reduced repeat interventions and better outcomes.
Abstract

Keywords:
HandHand InjuryHand SurgeryPediatricPlastic SurgeryQuality Improvement

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